HIV Infection in Sexually Transmissible Disease Practice in Sydney: The Effects of Legislation, Public Education and Changing Clinical Spectrum

The experience with human immunodeficiency virus (HIV) infection of a private inner-city sexually transmissible diseases (STD) clinic in Sydney was quantified. Between February 1984 and March 1988, 2073 of the Clinic's patients were tested for antibodies to HIV on 5095 occasions. Of those tested, 538 (26%) were positive for antibodies to HIV: 532 (98.9%) of the seropositives had practised male homosexual intercourse. This is the highest reported seroprevalence of HIV for any primary care service in Australia. Those individuals seropositive because of other risk behaviours were detected by voluntary contact tracing rather than by screening. Female prostitution was not found to be a risk factor for HIV. In general, rates of first HIV antibody tests were adversely affected by threatening legislation, and temporarily stimulated (among lower-risk persons) by a national television campaign. These data suggest that much of the counselling, detection and management of HIV infection in Australia is occurring in private practice, and that STD services (private and public) are at the forefront of the HIV epidemic. This has implications for disease surveillance and control, health services planning and medical education.

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艾滋病防治中的倫理和政策問題

International Journal of Chinese & Comparative Philosophy of Medicine ◽

10.24112/ijccpm.11348 ◽

1998 ◽

Vol 1 (4) ◽

pp. 7-60

Author(s):

Ren-Zong QIU

Keyword(s):

Public Health ◽

Hiv Infection ◽

Infection Rate ◽

Health Professionals ◽

Ethical Issues ◽

Casual Sex ◽

Contact Tracing ◽

Public Health Approach ◽

Treatment And Prevention ◽

Hiv Epidemic

LANGUAGE NOTE | Document text in Chinese; abstract also in English.本文討論了艾滋病在中國大陸傳播引起的倫理和政策問題。作者首先指出在預防控制艾滋病問題上中國正處在十字路口。挨著作者分析了中國會不會成為艾滋病和艾滋病病毒感染的高發國，討論了制訂有效而合乎倫理的艾滋病防治政策的理論預設和價值以及評價政策的倫理學框架，討論了艾滋病治療和預防中的倫理和政策問題。The AIDS/HIV prevention and control in China is at crossroad. At present, there are insufficient grounds for us to say that China will definitely become a country with a high HIV infection rate in the future. However, we have much less sufficient grounds for saying that China will never reach that stage. On the contrary, we have much more reason to say that it is very probable for China to become a country with high HIV infection rate if we leave the current policy unchanged. The reasons are: economic reforms associated with large scale population movements in unprecedented way; proliferation of all sorts of high risk behavior, presence of other STDs which facilitate the spread of HIV; the risk of iatrogenic spread through untested blood transfusion; the "sex revolution" with changes in patterns of sex behaviour and increased casual sex, multiple sex partners among the younger generation; most Chinese still do not know how to protect themselves; and the ethical and legal atmosphere necessary for effectively preventing the HIV epidemic has not been formed.The conventional public health approach is not sufficient to prevent or control an HIV epidemic. When the cases of HIV infection were detected one by one in China, health professionals and programmers believed that they could take a conventional public health approach to cope with HIV epidemic. But they are wrong. HIV infection is an epidemic so special that the conventional public health measures such as testing, reporting, contact tracing, isolation are inadequate or ineffective to control the epidemic. HIV is often spread among those groups who are usually marginalized or stigmatized by society through behaviours both confidential or private.An effective policy of preventing HIV cannot be insensitive to ethical issues. However, many of health professionals and programmers bypassed ethical issues emerged in the prevention of the HIV epidemic. Even some health educators, sexologists and officials believe that "AIDS is the punishment by God" or "AIDS is the punishment for promiscuity". For them suffering AIDS is not morally irrelevant, and thus the ancient conception of disease was revived. But this conception of disease has already proved wrong and harmful to the treatment and prevention of any disease, especially to HIV. The consequence entailed by this conception is that the IIIV positive and AIDS patients were discriminated against and stigmatized. When their positive serological status was disclosed, they were faced with the risk of being expelled from school or fired from working unit, even rejected for admission into hospital, and their tights to confidentiality and privacy were often infringed upon. If all these ethical issues cannot be properly treated, how can those persons in danger or risk get access to information, services, education, counselling and techniques necessary to prevent HIV infection? One Chinese adage says that "You cannot have fish and bear palm both". In the prevention of HIV epidemic we have to have the protection of public health and the safeguarding of individual rights.For controlling HIV epidemic what we need is not a repressive law, but a supportive law to build a supportive environment in treatment and prevention of AIDS/HIV. So the policy and law involving AIDS/ HIV should be reformed.DOWNLOAD HISTORY | This article has been downloaded 19 times in Digital Commons before migrating into this platform.

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Why the HIV Reservoir Never Runs Dry: Clonal Expansion and the Characteristics of HIV-Infected Cells Challenge Strategies to Cure and Control HIV Infection

Viruses ◽

10.3390/v13122512 ◽

2021 ◽

Vol 13 (12) ◽

pp. 2512

Author(s):

Chuen-Yen Lau ◽

Matthew A. Adan ◽

Frank Maldarelli

Keyword(s):

Hiv Infection ◽

Clonal Expansion ◽

Marrow Transplant ◽

Clinical Events ◽

Immunodeficiency Virus ◽

Latently Infected ◽

Hiv Eradication ◽

Infected Cells ◽

And Control ◽

Number Of Individuals

Antiretroviral therapy (ART) effectively reduces cycles of viral replication but does not target proviral populations in cells that persist for prolonged periods and that can undergo clonal expansion. Consequently, chronic human immunodeficiency virus (HIV) infection is sustained during ART by a reservoir of long-lived latently infected cells and their progeny. This proviral landscape undergoes change over time on ART. One of the forces driving change in the landscape is the clonal expansion of infected CD4 T cells, which presents a key obstacle to HIV eradication. Potential mechanisms of clonal expansion include general immune activation, antigenic stimulation, homeostatic proliferation, and provirus-driven clonal expansion, each of which likely contributes in varying, and largely unmeasured, amounts to maintaining the reservoir. The role of clinical events, such as infections or neoplasms, in driving these mechanisms remains uncertain, but characterizing these forces may shed light on approaches to effectively eradicate HIV. A limited number of individuals have been cured of HIV infection in the setting of bone marrow transplant; information from these and other studies may identify the means to eradicate or control the virus without ART. In this review, we describe the mechanisms of HIV-1 persistence and clonal expansion, along with the attempts to modify these factors as part of reservoir reduction and cure strategies.

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Contact Tracing for Human Immunodeficiency Virus (HIV) Infection

Sexually Transmitted Diseases ◽

10.1097/00007435-199017010-00008 ◽

1990 ◽

Vol 17 (1) ◽

pp. 37-41

Author(s):

KRISTINA RAMSTEDT ◽

GUNILLA HALLHAGEN ◽

BRITT-INGER LUNDIN ◽

CHARLES HAKANSSON ◽

GUNNAR JOHANNISSON ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Hiv Infection ◽

Contact Tracing ◽

Immunodeficiency Virus

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Depressive Syndromes and Symptoms in Subjects with Human Immunodeficiency Virus (HIV) Infection

The British Journal of Psychiatry ◽

10.1192/s0007125000298498 ◽

1996 ◽

Vol 168 (S30) ◽

pp. 117-122 ◽

Cited By ~ 31

Author(s):

Mario Maj

Keyword(s):

Human Immunodeficiency Virus ◽

Depressive Symptoms ◽

Hiv Infection ◽

Social Rejection ◽

Hiv Epidemic ◽

The Social ◽

Immunodeficiency Virus ◽

Depressive Syndromes ◽

Aids Study ◽

Hiv Seropositive

The association between the infection produced by the human immunodeficiency virus (HIV) and syndromal or subsyndromal depression has been the topic of several studies in recent years. The results of the WHO Neuropsychiatric AIDS Study, conducted in the five geographical areas predominantly affected by the HIV epidemic, suggest that the symptomatic stages of HIV infection are associated with an increased prevalence of depressive symptoms, and, at least in some contexts in which the spreading of the infection is more recent and the social rejection of HIV-seropositive subjects is harsher, may also be associated with an increased prevalence of a syndromal diagnosis of depression.

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Peculiarities of the Spread of HIV infection among Urban and Rural Residents of the Tyumen Region

Epidemiology and Vaccinal Prevention ◽

10.31631/2073-3046-2021-20-5-98-106 ◽

2021 ◽

Vol 20 (5) ◽

pp. 98-106

Author(s):

E. N. Mel`nikova ◽

A. N. Marchenko

Keyword(s):

Hiv Infection ◽

Geographic Location ◽

Epidemiological Data ◽

Rural Residents ◽

Regional Center ◽

Hiv Epidemic ◽

Urban And Rural Residents ◽

And Control ◽

The City ◽

Vast Territory

Relevance. The geographical spread of HIV infection among the population of various administrative territories is very heterogeneous. The Tyumen region, due to its vast territory and the significant remoteness of some areas from the regional center, is of particular interest in the framework of considering the territorial features of the spread of HIV.Aims. To consider peculiarities of the spread of hiv infection among urban and rural residents of the Tyumen region in 1993–2019.Materials & Methods. Statistical data of the «Center for the Prevention and Control of AIDS» in the period from 1993 to 2019, annual form No. 61 «Information on the contingents of HIV patients» for 2006–2019, materials of the state report «On the sanitary and epidemiological situation in the Tyumen region» for 2013–2019. Methods of epidemiological observation were used in the work: analytical and descriptive-evaluative with the use of methods of retrospective and operational analysis and statistical methods.Results and Discussions. A specific feature of the spread of HIV infection among urban and rural residents is the tendency to exceed the regional incidence rate in a number of territories. Analysis of epidemiological data for the period under review showed that all territories of the region are involved in the epidemiological process of HIV infection, and in a number of territories the prevalence rate exceeds the average Russian level. HIV prevalence as of December 31, 2019 was 728.2 per 100 thousand people in Russia. In 17 administrative territories of the Tyumen region the infection rate is higher than the national average level and is per 100 thousand population in the city of Tobolsk – 1903.3, in the districts of Uvat – 1486.2, Tobolsk – 1440.5, Nizhnetavda – 1354.9, Tyumen – 1344.1, Yalutorovsk – 1327.6), in the city. Tyumen – 1249.3, in the districts: Vagay – 1195.2, Zavodoukovsky – 1119.2, in Ishim – 951.8, in the districts: Yarkovsky – 889.6, Vikulovsky – 881.3, Yurginsky – 846.9, Ishimsky district – 842.1, Aromashevsky – 851.6, Isetovsky – 754.4, Uporovsky district – 734.7.Conclusions. The HIV epidemic in the Tyumen region is determined by its economic and geographic location and by the presence of exceptional epidemiologically significant prerequisites for the intensive spread of HIV, in particular, by the routes through which large quantities of drugs are illegally transported (drug trafficking from the northeast).

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Strengthening Tuberculosis Prevention and Control in Nigeria: Exploring Integrated Approach

COJ Nursing & Healthcare ◽

10.31031/cojnh.2018.02.000541 ◽

2018 ◽

Vol 2 (4) ◽

Author(s):

Ogbonna BO

Keyword(s):

Hiv Infection ◽

Disease Surveillance ◽

Prevention And Control ◽

English Language ◽

Integrated Approach ◽

The Body ◽

Hiv Positive ◽

Integrated Strategies ◽

Tuberculosis Prevention ◽

And Control

Tuberculosis (TB) is an infectious disease caused by mycobacterium tuberculosis, and usually affects the lungs and other parts of the body. Patients with HIV infection are particularly more susceptible to wider varieties of mycobacterium strains. This study discussed integrated strategies of tuberculosis prevention and control for improved population health. The study discussed relevant documents and literatures written in English Language from reorganized websites. Key words were used individually and in series with truncations where necessary. Government can aid the control of tuberculosis by providing good shelter, improved mass literacy programmes on the predisposing factors and prevention. The need to improve the standard of living, reduction of hunger and starvation is essential. The incidence worldwide stood at the rate of 10-20/100,000 per year with low mortality; deaths occurring mainly in the elderly and occasionally in undiagnosed cases. About 10% of all HIV-positive individuals harbor TB. That is 400 times the rate associated with the public. Only 3-4% of infected individuals develop the active disease upon initial infection, 5-10% within one year. In cases of HIV infection the percentages are much higher because HIV infection tends to fuel the reactivation of existing TB infection as well as promote new infections. Integrated strategies will reduce the prevalence of TB especially among the HIV positive patients that are more vulnerable. Promotion of rational drug use, scaling up disease surveillance, monitoring and evaluation, and improving access to diagnostic centers are essential for improved prevention and control. Government policies targeted towards overcrowding prevention, and increased funding for TB research and development will boost and sustain already existing efforts. These processes in a continuum will boost sustainability.

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Progress in the Prevention and Treatment of AIDS Associated with Tuberculosis

Infection International ◽

10.1515/ii-2017-0129 ◽

2016 ◽

Vol 5 (2) ◽

pp. 44-49 ◽

Cited By ~ 1

Author(s):

Wenlong He ◽

Rui Li ◽

Yaogang Wang

Keyword(s):

Hiv Infection ◽

Opportunistic Infections ◽

Epidemiological Studies ◽

Public Health Care ◽

Rapid Progression ◽

The Public ◽

Immunodeficiency Virus ◽

Latent Tb ◽

Latent Tb Infection ◽

And Control

AbstractEpidemiological studies have shown that infection with the human immunodeficiency virus (HIV) is an influential risk factor for infection withMycobacterium tuberculosis(MTb), the rapid progression of the initial infection to active tuberculosis (TB), and the reactivation of latent TB infection. MTb infection is also one of the most common opportunistic infections in people with HIV, including AIDS patients receiving anti-retroviral therapy. Given the prevalence of HIV infection, the incidence of TB infection, which had begun to decline, is facing a severe situation. HIV associated with TB exerts an immense burden on the public health-care system, especially in countries with high incidences of HIV infection. Therefore, the global policies for the prevention and control of TB should be revised. Moreover, an increased investment in TB control has to be guaranteed. The purpose of this review is to summarize the recent progress in the prevention, treatment, and control of HIV and TB co-infection.

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Lost and found: applying network analysis to public health contact tracing for HIV

Applied Network Science ◽

10.1007/s41109-021-00355-w ◽

2021 ◽

Vol 6 (1) ◽

Author(s):

Dana K. Pasquale ◽

Irene A. Doherty ◽

Peter A. Leone ◽

Ann M. Dennis ◽

Erika Samoff ◽

...

Keyword(s):

North Carolina ◽

Network Analysis ◽

Disease Surveillance ◽

Time Window ◽

Temporal Trends ◽

Contact Tracing ◽

Infectious Disease Surveillance ◽

Hiv Epidemic ◽

Lost And Found ◽

Network Component

AbstractInfectious disease surveillance is often case-based, focused on people diagnosed and their contacts in a predefined time window, and treated as independent across infections. Network analysis of partners and contacts joining multiple investigations and infections can reveal social or temporal trends, providing opportunities for epidemic control within broader networks. We constructed a sociosexual network of all HIV and early syphilis cases and contacts investigated among residents of 11 contiguous counties in North Carolina over a two-year period (2012–2013). We anchored the analysis on new HIV diagnoses (“indexes”), but also included nodes and edges from syphilis investigations that were within the same network component as any new HIV index. After adding syphilis investigations and deduplicating people included in multiple investigations (entity resolution), the final network comprised 1470 people: 569 HIV indexes, 700 contacts to HIV indexes who were not also new cases themselves, and 201 people who were either indexes or contacts in eligible syphilis investigations. Among HIV indexes, nearly half (48%; n = 273) had no located contacts during single-investigation contact tracing, though 25 (9%) of these were identified by other network members and thus not isolated in the final multiple investigation network. Constructing a sociosexual network from cases and contacts across multiple investigations mitigated some effects of unobserved partnerships underlying the HIV epidemic and demonstrated the HIV and syphilis overlap in these networks.

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